A Research Agenda for Malaria Eradication: Health Systems and Operational Research

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Abstract

The Malaria Eradication Research Agenda (malERA) Consultative Group on Health Systems and Operational Research outline a research and development agenda for the health systems research required for malaria eradication.

Abstract

Health systems research and development is needed to support the global malaria eradication agenda. In this paper, we (the malERA Consultative Group on Health Systems and Operational Research) focus on the health systems needs of the elimination phase of malaria eradication and consider groupings of countries at different stages along the pathway to elimination. We examine the difference between the last attempt at eradication of malaria and more recent initiatives, and consider the changing health system challenges as countries make progress towards elimination. We review recent technological and theoretical developments related to health systems and the renewed commitment to strengthening health systems for universal access and greater equity. Finally, we identify a number of needs for research and development, including tools for analyzing and improving effective coverage and strengthening decision making and discuss the relevance of these needs at all levels of the health system from the community to the international level.

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Achieving child survival goals: potential contribution of community health workers.

Andy Haines, David Sanders, Uta Lehmann … (2007)

There is renewed interest in the potential contribution of community health workers to child survival. Community health workers can undertake various tasks, including case management of childhood illnesses (eg, pneumonia, malaria, and neonatal sepsis) and delivery of preventive interventions such as immunisation, promotion of healthy behaviour, and mobilisation of communities. Several trials show substantial reductions in child mortality, particularly through case management of ill children by these types of community interventions. However, community health workers are not a panacea for weak health systems and will need focussed tasks, adequate remuneration, training, supervision, and the active involvement of the communities in which they work. The introduction of large-scale programmes for community health workers requires evaluation to document the impact on child survival and cost effectiveness and to elucidate factors associated with success and sustainability.

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An assessment of interactions between global health initiatives and country health systems.

(2009)

Since 2000, the emergence of several large disease-specific global health initiatives (GHIs) has changed the way in which international donors provide assistance for public health. Some critics have claimed that these initiatives burden health systems that are already fragile in countries with few resources, whereas others have asserted that weak health systems prevent progress in meeting disease-specific targets. So far, most of the evidence for this debate has been provided by speculation and anecdotes. We use a review and analysis of existing data, and 15 new studies that were submitted to WHO for the purpose of writing this Report to describe the complex nature of the interplay between country health systems and GHIs. We suggest that this Report provides the most detailed compilation of published and emerging evidence so far, and provides a basis for identification of the ways in which GHIs and health systems can interact to mutually reinforce their effects. On the basis of the findings, we make some general recommendations and identify a series of action points for international partners, governments, and other stakeholders that will help ensure that investments in GHIs and country health systems can fulfil their potential to produce comprehensive and lasting results in disease-specific work, and advance the general public health agenda. The target date for achievement of the health-related Millennium Development Goals is drawing close, and the economic downturn threatens to undermine the improvements in health outcomes that have been achieved in the past few years. If adjustments to the interactions between GHIs and country health systems will improve efficiency, equity, value for money, and outcomes in global public health, then these opportunities should not be missed.

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Applying clinical epidemiological methods to health equity: the equity effectiveness loop.

Peter Tugwell, Don de Savigny, Gillian Hawker … (2006)

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Journal

Journal ID (nlm-ta): PLoS Med

Journal ID (publisher-id): PLoS

Journal ID (pmc): plosmed

Title: PLoS Medicine

Publisher: Public Library of Science (San Francisco, USA )

ISSN (Print): 1549-1277

ISSN (Electronic): 1549-1676

Publication date Collection: January 2011

Publication date (Print): January 2011

Publication date (Electronic): 25 January 2011

Volume: 8

Issue: 1

Electronic Location Identifier: e1000397

Author notes

* E-mail: Marcel.Tanner@ 123456unibas.ch

MT is the corresponding author on behalf of the malERA Consultative Group on Health Systems and Operational Research. Chaired the group: MT. ICMJE criteria for authorship read and met: PA, DB, KH, KM, RDN, DdS, AS, LS, MT, TT. Participated in one or more discussion meetings resulting in the writing of this article: the malERA Consultative Group on Health Systems and Operational Research.

¶ Full listing of the members of the malERA Consultative Group on Health Systems and Operational Research can be found in the Acknowledgments.

Review articles synthesize in narrative form the best available evidence on a topic.

Article

Publisher ID: 10-PLME-ES-5705R1

DOI: 10.1371/journal.pmed.1000397

PMC ID: 3026705

PubMed ID: 21311588

SO-VID: deaa2e41-15bc-4a8f-be4c-292b82b4a55a

Copyright © The malERA Consultative Group on Health Systems and Operational Research. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

A Research Agenda for Malaria Eradication: Health Systems and Operational Research

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Malaria vaccine development

Most cited references 14

Achieving child survival goals: potential contribution of community health workers.

An assessment of interactions between global health initiatives and country health systems.

Applying clinical epidemiological methods to health equity: the equity effectiveness loop.

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